Recurrent breast cancer will develop again after initial treatment. Although the initial treatment aims to eliminate all cancer cells, there may still be some very small tumor cells left behind, which can multiply into recurrent breast cancer.
1. Recurrent breast cancer
Breast cancer can recur at any time or not at all, but most recurrences occur within the first 5 years after breast cancer treatment.
Recurrent breast cancer occurs when cells that were part of the patient’s original breast cancer separate from the tumor and hide nearby in the breast or in another part of the body, and then these cells begin to grow back. Chemotherapy, radiation therapy, and hormone therapy may be applied to patients diagnosed with breast cancer for the first time to aim to destroy cancer cells after surgery. However, these treatments cannot eliminate all cancer cells.
Sometimes cancer cells may remain inactive for many years without causing harm. But then, due to factors that stimulate the cells, they may start to grow and spread to other parts of the body.
Breast cancer can recur; however, it can be a local recurrence (meaning in the treated breast or near the surgical scar) or in another location in the body. Some of the most common external recurrence sites are lymph nodes, bones, liver, lungs, and brain.
2. Some signs of recurrent breast cancer
The signs and symptoms of recurrent breast cancer vary depending on where the cancer recurs.
2.1. Local recurrence
In local recurrence (recurrence at the site), cancer appears again in the same area as the original cancer. If the patient has undergone tumor removal surgery, cancer may recur in the remaining breast tissue. If the patient has undergone mastectomy, cancer may recur in the tissue along the chest wall or on the skin.
Signs and symptoms of locally recurrent breast cancer in the same breast may include: the appearance of a new lump in the breast; changes in skin color on the breast; dermatitis; nipple discharge.
Signs and symptoms of local recurrence on the chest wall after mastectomy include: the appearance of one or more painless nodules on or under the skin of the chest wall; the presence of new thickened areas along or near the surgical scar.
2.2. Regional recurrence
Regional recurrent breast cancer means that cancer has developed again in nearby lymph nodes.
Signs and symptoms of regional recurrent breast cancer include: the appearance of a swollen lump in the lymph nodes under the arm, near the collarbone, in the groove above the collarbone, in the neck.
2.3. Distant recurrence
Distant recurrence of breast cancer means that breast cancer has metastasized, meaning the cancer has spread to other distant parts of the body. Common sites include bones, liver, and lungs.
Signs and symptoms of metastatic breast cancer include: persistent pain (such as chest pain or bone pain); persistent cough; difficulty breathing; loss of appetite; weight loss; severe headaches; and seizures.
3. Risk factors for breast cancer recurrence
For those who survive breast cancer treatment, factors that may increase the risk of disease recurrence include:
- Related to lymph nodes: Detection of cancer in nearby lymph nodes at the time of initial diagnosis increases the risk of cancer recurrence.
- Tumor size: Women with larger tumors will have a higher risk of breast cancer recurrence.
- Tumor margin status: During breast cancer surgery, the surgeon will try to remove the cancer along with a small amount of normal tissue surrounding it. However, a study by a pathologist found cancer cells at the edges of the tissue. If the margins are cancer-free upon microscopic examination (negative margins), but if any part of the margins has cancer cells (positive margins) or in the center of the tumor, the risk of cancer recurrence will increase.
- Lack of post-surgery radiation: Most women who choose to undergo wide local excision for breast cancer receive breast radiation to reduce the risk of recurrence. Women who do not receive radiation have a higher risk of breast cancer recurrence.
- Age: Younger women, especially those under 35 years old at the time of initial breast cancer diagnosis, will have a higher risk of breast cancer recurrence.
- Inflammatory breast cancer: Women with inflammatory breast cancer have a higher risk of local recurrence.
- Cancer cells: If a patient’s breast cancer does not respond to hormone therapy or targeted treatment for the HER2 gene (triple-negative breast cancer), there may be a high risk of disease recurrence.
4. Some preventive measures
Methods related to reducing the risk of breast cancer recurrence include:
- Hormone therapy: Women with hormone receptor-positive breast cancer can reduce the risk of breast cancer recurrence by undergoing hormone therapy after initial treatment.
- Chemotherapy: For women with breast cancer at high risk of recurrence, chemotherapy has been shown to reduce the likelihood of cancer recurrence, and those who undergo chemotherapy often live longer.
- Radiation therapy: Women who have undergone breast surgery for breast cancer and those with large tumors or inflammatory breast cancer have a lower risk of breast cancer recurrence if they receive radiation therapy.
- Targeted therapy with HER2 gene: For women with HER2-positive breast cancer, using the drug trastuzumab (Herceptin) can reduce the risk of cancer recurrence.
- Maintaining a healthy weight: Maintaining an appropriate weight can help reduce the risk of cancer recurrence.
- Exercise: Regular physical activity can reduce the risk of cancer recurrence.
- Choosing a healthy diet: A healthy diet to help reduce the risk of cancer recurrence can focus on foods such as green vegetables, fruits, and grains. Stimulants like alcohol and other stimulants should be avoided.
Breast cancer is a disease that causes a high mortality rate among women; it can be treated if detected and treated promptly, minimizing the risk of recurrence. In addition, each woman must also protect her own health by self-examining and noticing any changes in the breasts and surrounding areas.
